One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide? In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Matt Heelan. Matt Heelan is the Chief Operating Officer at illumisoft, a mission-driven, custom healthcare software development company. He has over 20 years of experience in various areas such as operations, business development, and client services within technology companies within the legal, healthcare, and financial sectors. Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started? After college, I was lucky to join a small business that provided professional services and technology to large, national law firms. The reason I felt lucky was that I was able to learn everything about what it takes to operate and grow a small business. I was able to learn about finance, marketing/advertising, business development, and client/customer services. I like to tell people that over the 10 years I worked there I felt like I earned my “unofficial MBA.” My entire career I have been surrounded by technology and helping specific industries figure out the best way to be more efficient and reduce risk. When I joined illumisoft the company was focused on serving a wide variety of industries such as manufacturing, logistics, academia, and healthcare. It was my view and recommendation that given the deep relationships that we had built in healthcare we should modify the company strategy and focus solely on healthcare. We were in the middle of this shift when the pandemic happened, and we have seen a steady increase in the services we provide. The main theme we have heard from our clients has been simplification and integration in an effort again to be more efficient and reduce risk.
Can you share the most interesting story that happened to you since you began your career?
Back in 2014, I began pursuing a large multi-year business partnership with a large law firm in New Jersey. I built that relationship for over 2 years before they were ready to begin the work. During that time, the clients because of confidentiality reasons were very careful not to disclose who their client was and what the project was related to. Regardless, we were excited about it because of some of their ideas around using some new technologies and we knew that this could help us affirm our position as leaders in the market.
In October 2014, I received a call that they wanted me to fly to New York and make a presentation. The clients had asked if the CEO of the company could attend. The CEO of our company wanted to attend the meeting because of the sheer size and scale of the opportunity which was over $20 million dollars. We flew to New York and the morning of the presentation he called me and said, “I have food poisoning, so you’ll have to make the presentation and answer all their questions.” I had already prepared to make the presentation but was afraid of how his absence would look.
I made the presentation and by the next week, they agreed to move forward and signed a multi-year contract. I finally discovered that the project they wanted us to work on was the 9/11 clean-up victim’s lawsuit involving over 5000 individuals. The next week the cases went to arbitration and we never worked on the project.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I played baseball in college and my father coached me from the time I was 8 all the way through high school so he was naturally my number one fan. For the entire four years I played in college my dad did not miss a single game which included those games where I had to travel. After each game, my dad would find the newspaper with the box score that detailed my performance. He would cut them out of the newspaper and mail them to me. He would always have a note inside that would say, “Sometimes you may need to go back and read your old box scores.”
The lesson is that sometimes we need to be reminded of our past successes and what we have achieved against some very challenging situations and obstacles.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful for who helped get you to where you are? Can you share a story about that?
Honestly, my Mom and Dad. My father really taught me about hard work, dedication, honesty, and grit. Whereas my mother taught me about the value of education, compassion, and integrity. These values have been the bedrock that my career has been built on and has influenced the way that I have built organizations and the relationships that I maintained and nurtured during that time. The desire to be a part of a great team and do memorable work comes from my family's core principles of finding ways to serve others and improve their lives in some way.
Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?
To be clear, illumisoft is a custom software development company specializing in the healthcare industry. Our responses to these questions are based on information we have gathered over the years with our physician partners who have helped us develop these solutions. In addition, we routinely perform in-depth market analysis to understand our market trends and that informs how we are answering these questions.
Specifically, we talked about the benefits of treating people in person on our Podcast. The main benefit is the ability of physicians to build trust with another person. According to a report published by Sykes regarding Americans’ perception of telehealth during COVID-19, 23% of respondents said their biggest deterrent from making a future telehealth appointment was that they felt uncomfortable speaking with an unfamiliar healthcare professional. As human beings, we need that human connection or the sense of another person, especially with the topics of literal life and death.
Technology in healthcare is advancing at a very rapid pace, especially over the last 5 years but I find it hard to believe that telemedicine will be the only way that we interface with the medical community. I still believe that we are moving into this hybrid model where we can maintain the human connection but also tap into the value of the technology. In the same Sykes poll when people were asked, “Do you feel that people get comparable health care through telehealth as they do for in-person visits?” 31% answered no but telehealth is a good option for the initial consultation and other basic care.
On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?
a. Again, the ability to build trust with patients and in some cases deliver a difficult, serious diagnosis.
b. The ability to perform a thorough physical examination of the person.
c. Increases the potential for misdiagnosis.
d. State regulations compliance. In the state of Arkansas, if a physician prescribes medication, they must perform an in-person exam.
e. The “Reimbursement question.” What happens post-pandemic? Is it worth the investment for physicians to make in technology?
f. Privacy and potential legal issues. Do your video calls maintain patient confidentiality requirements?
Case Study: Failure to Diagnose and Treat
Events
A 62-year-old obese patient with an ankle injury
ER surgical consult, cast applied
Three weeks later, contact a physician for a telemedicine visit
New swelling of the leg
Advised to elevate the leg and see an orthopedic surgeon within 24 hours
MD ordered a Doppler ultrasound for 12:30 that afternoon
EMS called at noon
The patient is unresponsive, in full arrest
Patient died
Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You?
(Please share a story or example for each.)
1. Act as if the camera is always on. We have all had this happen in our own personal and professional lives when we forget the camera or sound is not muted. We do not want to accidentally hear our physician make an embarrassing comment nor do we want to hear the dog barking in the background if we are the physician.
2. Patients reported higher levels of satisfaction when their physician was wearing clean white lab coats or scrubs.
3. Physicians avoid multi-tasking during the patient’s appointment. Patients deserve your undivided attention just as if they were in front of you.
4. Physicians understand the technology so that they can deliver a solid patient-centered experience. A patient will not be put at ease if the physician seems to have difficulty operating the technology.
5. Physicians, if you are vetting certain telehealth technology providers remember your patient population and their likely level of comfort with the technology.
Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?
1. Expanded sources of revenue for hospitals, physicians, clinics, and groups. Prior to the larger adoption of telemedicine, your revenue was limited to a local or regional population or the willingness of patients to travel to your practice or clinic. A lot of physicians can now see patients on a nationwide basis and patients’ options for care have drastically expanded.
2. Expand care and reach more patients. As a physician, your ability to maximize the impact you have on a given population has grown enormously. As an example, one of the projects we are working on involves a large physician group that wants an RPM and telehealth solution built. Their goal is to be able to monitor their elderly population to truly be able to perform preventative medicine by routinely collecting data from these individuals and performing interventions before they become emergency room visits.
3. Reduces overhead. A telehealth visit simply costs your practice less than an in-person visit. A typical in-person office visit costs the doctor’s office $146.00 whereas the average telehealth visit costs $79.00.
Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?
Quick access.
User-friendly, intuitive design.
High-quality audio and video.
Chat/messaging.
Ease of scheduling appointments.
If you could design the perfect Telehealth feature or system to help your patients, what would it be? A system that saves lives. I believe that in the not-so-distant future you will see the combination of robust RPM (Remote Patient Monitoring) systems with wearables (for young and old) tied to data collected and sent to your primary care physician, insurance company, and healthcare system where they will leverage AI, AR, and machine learning to reduce deaths and make our population exponentially healthier. I envision these health wearables to be more easily integrated into our lives whether that be clothing that sends health data or where we take a pill that lives in our bodies that send signals to our doctor. Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? The importance of knowing your own health history and family history. Invest in some of the at-home tests like 23 and Me, Ancestry, etc. Be prepared for the appointment. This means removing any distractions from the room. You would not bring your dog to the in-person appointment. Be able to clearly communicate why you made the appointment. Be on time for your appointments. Technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you? In 2018 the US healthcare sector was worth $8.45 trillion and since COVID-19 it has significantly grown. Specifically, if you track the investment in healthcare over the last year by venture capital and corporate investment from the likes of Amazon, Walmart and most recently Microsoft you would think we have reached some inflection point to seriously begin the overhaul of our healthcare system. As Winston Churchill said, “Never waste a good crisis” the pandemic has proved to be a possible accelerant for us to transform our healthcare system. Yes, there are plenty of interesting technologies that are being developed around AR, VR, and Mixed Reality potentially targeting both the patient/consumer and the physician however there is also some more boring technology being used that will also impact your healthcare experience. This comes in the form of collecting and analyzing large healthcare data sets in the cloud, using machine learning and AI to analyze a population’s health, and determining where there are opportunities. Also, this same computing power can be used to analyze your DNA and look for signs of cancer like Grail.com/Galleri.com and Nightingalehealth.com. Is there a part of this future vision that concerns you? Can you explain? Privilege=Power=Access. There are enormous discrepancies in the future as to who will get access to some of these technologies in healthcare. If you are poor, you cannot afford Wifi therefore your access to telehealth is limited. If you are poor, you cannot afford healthcare and therefore you cannot afford an early detection test for cancer. We need to address the inequities in many parts of our society but beginning with a common agreement that healthcare is as much a human right as being able to freely speak. Unfortunately, we have seen this inequity in the distribution of the COVID-19 vaccine with richer countries securing supplies faster than the poorer countries while understanding that if we do not vaccinate the world, we may struggle to fully eliminate the virus. This should not be a rich vs. poor but a human being’s priority. Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-) Each country should partner with Amazon and Grail.com to distribute an early cancer detection test to the entire planet. Also, partnering with Illumina, to distribute DNA sequencing test to the entire plant. Each country should build their own national healthcare platform to store the data and then leverage machine learning to treat their entire population based on targeted therapies based on their test results. How can our readers further follow your work online? https://www.linkedin.com/in/mattheelan/ https://twitter.com/mheelan Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.
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